Failure to Follow Hand Hygiene Protocol During Incontinence Care
Penalty
No penalty information released
The penalty, as released by CMS, applies to the entire inspection this citation is part of, covering all citations and f-tags issued, not just this specific f-tag. For the complete original report, please refer to the 'Details' section.
Summary
During a review of infection control practices, it was observed that a certified nursing assistant (CNA) failed to follow proper hand hygiene protocols while providing incontinence care to a resident with severe cognitive impairment and functional urinary incontinence. After cleaning the resident and removing a soiled incontinence brief, the CNA did not change gloves or perform hand hygiene before applying a new brief. This was confirmed during an interview with the CNA, who acknowledged not changing gloves or performing hand hygiene after contact with urine. Facility policy requires hand hygiene with soap and water when hands are visibly soiled or contaminated with body fluids, in accordance with CDC and WHO standards.